| NPI | 1730344920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207X00000X Orthopaedic Surgery (Licence: IA 40376) |
| Additional Taxonomies | 207X00000X Orthopaedic Surgery (Licence: OH 35096532) |
| Enumeration Date | 2008-07-28 |
| Last Update Date | 2014-02-09 |